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Immunotherapy for Allergies to Insect Stings

Treatment Overview

Immunotherapy for insect sting allergies is a series of allergy shots
given to reduce your sensitivity to
allergens that cause an allergic reaction. Small doses
of allergens are injected under the skin. Over time, allergy shots can reduce
the severity of your reaction to allergens. To treat
allergies to insect stings, very small amounts of the
venom of the insect or insects are used. The treatment also is sometimes called
venom immunotherapy (VIT).

Immunotherapy is available to treat
allergies to stings from:

Honeybees.

Yellow
jackets.

Hornets.

Paper wasps.

Fire
ants.

A solution of dilute saline containing a very small amount
of the insect venom is injected under the skin. At first, you get one or more
shots about once a week. The amount of allergen injected is slightly increased
each time, unless you have a reaction to the shot.

After about 4
to 6 months of weekly shots, you are usually getting an optimal amount of
allergen in the shot—this is called the maintenance dose. After you reach
maintenance level, you get the same dose in shots every 4 weeks for another 4
to 6 months.

After the first year of shots, you will have
maintenance shots every 6 to 8 weeks over the next 3 to 5 years.footnote 1

Depending on your situation, your doctor may recommend
rush immunotherapy. Several shots are given over a
period of days to weeks. This type of treatment can provide faster protection
in the short term. But you will still need to have regular shots over the long
term.

For more information
about what to consider if you are thinking about having immunotherapy, see:

What To Expect After Treatment

Allergy shots are usually given in a
doctor's office. It is normal to stay in the doctor's office for a short time
after getting an allergy shot to be watched for possible serious reactions to
the injected insect venom.

Redness and warmth at the shot site are
common but go away after a short time.

Why It Is Done

Immunotherapy can prevent
life-threatening reactions and also reduce anxiety associated with insect
stings.

An allergic reaction that spreads far from the sting or
that affects the entire body is called a systemic reaction. Systemic reactions
are not common but can be life-threatening. Allergy shots are usually
recommended if an adult or child has had a severe systemic reaction, especially
anaphylaxis. Immunotherapy reduces the risk of another
severe systemic reaction.

How Well It Works

Immunotherapy for insect stings
can reduce your chances of having another severe systemic allergic
reaction from 60% to about 5%.footnote 1

It is
not clear exactly how effective the protection against future stings is after
the treatment has ended. In about 80 to 90 out of 100 cases, people who were treated will still be
protected against systemic reactions even if tests show some remaining immune
sensitivity.footnote 1

Risks

Allergy shots are safe if the shots are given
correctly. The most common side effects are redness and warmth at the shot
site. Some people may have large local reactions that include itching,
hives, or swelling of the skin near where you had the shot. More serious but
less common side effects include systemic symptoms such as
hives, itching, or difficulty breathing.

In rare cases, a person may have a severe allergic reaction (anaphylaxis)
to the shots. Because of this possibility, the shots are given in a doctor's
office or other setting where emergency care can be provided if needed.

Are taking ACE
inhibitors, such as captopril (Capoten, for example) or lisinopril (Prinivil,
Zestril, or Zestoretic, for example), which are often prescribed for
high blood pressure and a variety of heart conditions.
Talk to your doctor first about the potential risks of immunotherapy.

Are not able to communicate about reactions
to shots. Most doctors do not give allergy shots to children younger than age
5.

What To Think About

People with multiple insect venom
allergies may still be at risk for a severe systemic reaction if they are
receiving allergy shots for only one type of insect venom.

Immunotherapy is typically not needed for adults or children who have
only a large local reaction to a sting. But anyone who experiences increasingly
severe large local reactions with each new sting may want to consider
immunotherapy.

Allergy shots take 3 to 5 years to complete and are
expensive. You have protection from insect sting allergies after you have had
the series of initial shots and after you start your maintenance dose. This may
take about 1 to 2 months for standard immunotherapy but only 1 to 8 days with
rush immunotherapy.

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